Claims Analyst Insight GlobalClaims AnalystRed Bank, NJ$25–$29 / hourFull timeThis person will be responsible for working outstanding insurance claims, troubleshooting denials, reviewing EOBs, following up with payers, and helping resolve aged receivables across both in-network and out-of-network claims. This individual will join a high-volume medical billing and revenue cycle team, focusing on insurance claim resolution, denials, AR follow-up, and collections across both in-network and out-of-network claims.
NewRevenue Operations and Monetization Analyst Vaco LLCRevenue Operations and Monetization AnalystNew York, NY$60,000–$65,000 / yearDetermining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to: the individual’s skill sets, experience and training; licensure and certification requirements; office location and other geographic considerations; other business and organizational needs. With that said, as required by local law, Vaco by Highspring believes that the following salary range referenced above reasonably estimates the base compensation for an individual hired into this position in geographies that require salary range disclosure.
NewClaims Analyst Pharmacy Revenue Cycle Boston Medical CenterClaims Analyst Pharmacy Revenue CycleNY$56,000–$78,500 / yearUnder the direction of the Revenue Cycle Supervisor Pharmacy, the Revenue Cycle Claims Analyst is responsible through extensive telephone and written correspondence, will pursue insurance companies for payment or underpayment of services rendered. Collaborates with team and other revenue cycle departments to improve denials, avoidable write-offs, Applies analytical skills to pre-established work processes that may require preparation of reports or documents for further review or analysis.
Junior Claims Analyst - Reinsurance Hamilton Insurance Group LtdJunior Claims Analyst - ReinsuranceNew York, NY$60,000–$90,000 / yearBachelor's degree or equivalent work experience preferred 1 to 5 years' experience in claims administration, (re)insurance operations, or a related field preferably within the insurance and/or reinsurance industry Attention to detail with the ability to handle high volumes of data accurately Ability to prioritize and manage deadlines Strong analytical and problem-solving abilities Excellent written and verbal communication skills Willingness to develop varied skills and knowledge within a fast-paced and growing insurance and reinsurance company Proficiency in Microsoft Office suite and database systems, with strong working knowledge of PowerPoint and Excel Knowledge of ImageRight, SICS or a similar claims system is an advantage Ability to incorporate changing processes with AI adoption Strong communications skills Ability to work both independently and collaboratively as part of a team. Triaging: Assess, prioritize, and route incoming claims communications based on urgency and complexity across the reinsurance claims team Setting up first notices of loss Communicate with brokers regarding reinsurance claims Adjust and process daily reinsurance claim activity across a variety of classes based on contract terms Examine new and existing reinsurance claims Evaluate actual and potential exposures, and recommend accurate and timely reserves and payments Collaborate with other functions across the company to provide periodic updates on reinsurance claim matters Prepare reports and communicate findings in regular claim meetings Update and maintain claim records within claims systems to ensure accuracy and completeness.
Health Plan Claims Analyst I- Environmental Medicine Mount Sinai Health SystemHealth Plan Claims Analyst I- Environmental MedicineNew York, NY$64,526.72–$81,675 / yearMount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time - discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology.
Logistics Liability Claims Analyst Kuehne + Nagel International AGLogistics Liability Claims AnalystJersey City, NJYou will apply broad transportation and knowledge of the applicable international and domestics transportation laws, drive accurate claims data processing, lead recovery efforts, manage litigated files, and provide expert guidance to internal teams and customers. Manage mid to high value logistics liability claims, including maritime, warehouseman's legal liability, freight forwarding, airfreight liability, and road logistics.
HealthCare Claims Analyst Village CareHealthCare Claims AnalystNew York, NY$65,294.40–$72,277 / yearFull timeYou will play a critical role in understanding healthcare reimbursement from both financial and operational perspectives, conducting audits, and performing root cause analysis to resolve identified issues with internal teams and third-party administrators (TPAs). To excel as a Full-Time HealthCare Claims Analyst at VillageCare, candidates must possess a Bachelor's Degree in a relevant field such as Computer Science, Mathematics, Statistics, or Engineering, with a Master's degree preferred.
Employment Practices Liability Claims Analyst The Hartford Insurance Group IncEmployment Practices Liability Claims AnalystNew York, NY$82,800–$124,200 / yearCandidates should demonstrate the following competencies: Excellent oral and written communication skills; Strong strategic thinking abilities and execution skills; An ability to communicate thoughts clearly and concisely, and to influence and persuade others; Superior interpersonal skills, with an ability to work well as part of a team and/or in supporting roles. Experience, education and skills: Bachelor's degree required; professional designation and/or legal degree a plus; Insurance company (or law firm) experience a plus; Basic knowledge/understanding of professional lines, and/or litigated coverage and liability exposure desired; EPL a plus.
Claims Analyst IV - Management Liability American International GroupClaims Analyst IV - Management LiabilityNew York, NY$70,000–$89,000 / yearAs a Claims Analyst IV, this role will be responsible for handling Directors & Officers Liability Claims with opportunity to handle Employment Practices Liability claims, identifying, investigating, and resolving multiple coverage issues at the earliest appropriate time and providing clear and concise written and verbal communication of policy coverage issues to insureds, brokers, underwriters and risk managers. Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience.
Epic HB & HB Claims Analyst Computer Task Group, IncEpic HB & HB Claims AnalystNYRemote$120,000–$130,000 / yearDuration: 2-Year Contract Location: Remote (Must work West Coast business hours) On-Call Requirement: Participation in scheduled on-call rotation required Position Summary We are seeking an experienced Epic HB Home Health Billing Analyst to support the ongoing optimization, maintenance, and enhancement of Epic revenue cycle workflows related to Home Health services. The ideal candidate will possess an active Epic Hospital Billing (HB) certification and demonstrate hands-on experience supporting Home Health billing, charge capture, claims processing, reimbursement, and revenue cycle operations within Epic.
Associate Claims Analyst - MNA Claims Triage Markel Group IncAssociate Claims Analyst - MNA Claims TriageNew York, NY$25.11–$34.52 / hourThis includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Triaging of new claims includes identifying catastrophic claims, reviewing provided facts and/or obtaining additional facts from the reporting party, reviewing necessary policy coverage and evaluating the severity of the damages to complete the claims assignment to the appropriate claims specialist.
Sr. Claims Analyst, Primary Construction Allied World Assurance Company LtdSr. Claims Analyst, Primary ConstructionNew York, NY$110,000–$125,000 / yearHeadquartered in Bermuda, Allied World has offices in Atlanta, Boston, Brisbane, Chicago, Costa Mesa, Dallas, Dublin, Farmington (CT), Hong Kong, Houston, London, Los Angeles, Malaysia, Manchester, Miami, Nashville, New Jersey, New York, Philadelphia, San Francisco, Singapore, Sydney, Switzerland and Toronto. Job Requirements: A minimum of four (4) years of experience handling liability insurance claims or related relevant experience, including General Liability claims in the construction context (Construction Defect) and Casualty claims, with specific experience handling New York Labor Law matters.
Reinsurance Claims Analyst American International Group Inc (AIG)Reinsurance Claims AnalystJersey City, NJThat is why we created our Total Rewards Program, a comprehensive benefits package that extends beyond time spent at work to offer benefits focused on your health, wellbeing and financial security-as well as your professional development-to bring peace of mind to you and your family. American International Group, Inc. (AIG) is a global leader in commercial and personal insurance solutions; we are one of the world's most far-reaching property casualty networks.
Claims Analyst IV-Auto and GL American International Group Inc (AIG)Claims Analyst IV-Auto and GLJersey City, NJ$72,500–$96,700 / yearOur Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. That is why we created our Total Rewards Program, a comprehensive benefits package that extends beyond time spent at work to offer benefits focused on your health, wellbeing and financial security-as well as your professional development-to bring peace of mind to you and your family.
Claims Analyst Iv-Auto And GL American International GroupClaims Analyst Iv-Auto And GLJersey City, NJ$72,500–$96,700 / yearOur Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. That is why we created our Total Rewards Program, a comprehensive benefits package that extends beyond time spent at work to offer benefits focused on your health, wellbeing and financial security-as well as your professional development-to bring peace of mind to you and your family.
Senior Claims Analyst RelatedSenior Claims AnalystNew York, New York$140,000–$150,000 / yearResponsibilities include but not limited to: As a member of the Risk Management Department, assist the Director, Construction Claims in the documentation and administration of internal and external claim related matters, including Coordination with internal stakeholders on appropriate and timely reporting of incidents/claims; ensure all claims are reported to the appropriate insurer(s) and notice is provided to internal constituents as necessary; and verify timely TPA/insurer responses. Strong sense of integrity and ethics, values entrepreneurialism, demonstrates strong intellectual curiosity; always seeking new approaches and challenging the organization to new levels of success.
Senior Claims Analyst Severity American International Group Inc (AIG)Senior Claims Analyst SeverityJersey City, NJ$76,000–$103,000 / yearOur Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. The severity of these claims range from auto accidents with moderate injuries to multi-claimant litigation with severely injured plaintiffs, wrongful death, burn injuries, or property damage claims in the millions of dollars.
Senior Hospital Applications Analyst (Epic Resolute Claims and Remittance) University Hospital, Newark NJSenior Hospital Applications Analyst (Epic Resolute Claims and Remittance)Newark, New Jersey$89,754–$108,480 / yearFull timeAs the principal teaching affiliate of Rutgers New Jersey Medical School and the only state-certified Level 1 Trauma Center in Northern New Jersey, University Hospital is training the next generation of physicians and advancing science to discovery while taking exceptional care of patients, regardless of their financial situation. Works closely with financial, IT, and Revenue Cycle teamsto optimize Epic programming, configuration, and workflowsfor claims and remittance.
Claims Bus Tech Analyst II Horizon Healthcare ServicesClaims Bus Tech Analyst IINewark, New JerseyResponsible for coordination throughout the Service Division of all Claims Operations' technical requirements including global inventory reporting and aged claims analysis; claims stop governance, monitoring and maintenance; NASCO issue coordination and system request prioritization, submission and installation; files and table management; BRD review and subject matter expertise; Open Connect and BPM opportunity assessment and execution; EDI gateway claim edit project assessment and completion; general business level technical support for CSRs, PLogs, configuration, file updates and other projects. This technical analyst position is required in order to create a critically needed Service Division Claims Business Technical team to support the successful implementation of automation and efficiency projects/programs to ensure the achievement of claims timeliness and quality goals.
Senior Manager - Data Analyst for Medical Health Claims ExlService Holdings IncSenior Manager - Data Analyst for Medical Health ClaimsNY$120,000–$125,000 / yearThe ideal candidate retrieves, organizes and performs research/analysis on Medical Health Claim data primarily to identify root cause and is a proactive thinker, self-starter, who enjoys working in a fast-paced and challenging environment with the ability to work independently. The Senior Data Analyst will support the business team in evaluating trends on utilization of products / services based on historical data - such as care management trends, claim utilization, member attributes, to develop cost effective quality product / services.
Claims Review Analyst EmblemHealth IncClaims Review AnalystNew York, NY$48,600–$83,160 / yearIdentify potential/actual claims problems (single or recurring/trending) and document root cause analysis; present findings to management. Review and analyze suspected underpaid and overpaid claims from hospital, ancillary, and provider groups based on contractual and industry guidelines.
Senior Business Analyst, Claims and Vendor Data EmblemHealth IncSenior Business Analyst, Claims and Vendor DataNew York, NY$68,040–$118,800 / yearProven ability to apply quantitative and/or qualitative research and data analysis techniques to improve operational processes; and to identify and interpret trends, patterns, and anomalies within complex datasets of trend information required. Analyze and interpret claims, payment, and vendor data to identify, prevent, and recover overpayments, as well as to drive process improvements and cost containment.
NewClaims Negotiation Analyst (Out of Network Mandates) Horizon Healthcare ServicesClaims Negotiation Analyst (Out of Network Mandates)Newark, New JerseyPrepares written responses including negotiation outcomes by completing a written justification on how Horizon BCBSNJ adjudicated the initial and adjusted claim, but not limited to, benefits, contracts, payment and pricing methodology, proof of plan and providing explanation of benefits within regulated timeframes. $58,029 - $77,074 This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity.
Claims Module Senior Business Analyst Conduent IncClaims Module Senior Business AnalystNY$85,470–$111,000 / yearThrough our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. Should be able to run queries and perform basic system analysis, RCA etc., Should work closely with the client and development team during the stages of development, and conduct demos at completion of milestones, track and close feedback from such demos.
EPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full Time SolutionHealthEPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full TimeNJEpic Application Analysts 2-4 require current Epic training status (certification, accreditation, and/or proficiency) in primary application required, with a combination of current Epic training statuses in additional area(s) in application maintenance and development required in upper levels. Ideal candidates will possess strong experience as analyst with expert knowledge and experience in leading system analysis with special emphasis on system methodologies, projects management and business process reengineering related to information systems required.
Business Analyst, Claims VNS HealthBusiness Analyst, ClaimsNew York, NY$66,300–$79,800 / yearWorking closely with Claims Operations and cross-functional teams, this role identifies root causes, supports system enhancements, and helps ensure claims are processed accurately, efficiently, and in compliance with regulatory requirements. We're one of the largest nonprofit home- and community-based health care organizations in the country, and today, more than 11,500 team members work together to make a difference in the lives of more than 99,000 patients and members on any given day.
Business Analyst, Claims (Onsite 3 Days/Week) VNS HealthBusiness Analyst, Claims (Onsite 3 Days/Week)New York, New York$66,300–$79,800 / yearFull timeWorking closely with Claims Operations and cross-functional teams, this role identifies root causes, supports system enhancements, and helps ensure claims are processed accurately, efficiently, and in compliance with regulatory requirements. Effective oral and written communication skills, consulting and analytical skills and ability to work with clients, IT management, staff, consultants and vendors required.
Claims Data Quality Analyst Arch Capital Group LtdClaims Data Quality AnalystNew York, NY$62,000–$80,000 / yearCollaborate and maintain cross-functional working relationships with team members of multiple business units; Claims Third-party Administrators (TPA), Programmers, and approved vendors to analyze and correct data quality errors. Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs.
Analyst Developer IT Product, Claims Damco Solutions IncAnalyst Developer IT Product, ClaimsIselin, NJThe Full Stack Developer will support insurance technology initiatives involving Python, React, Node.js, AWS Serverless, and AI-driven transformation projects. Work with solution architects and engineering teams.
Technical Business Analyst with Medicaid & Claims Module experience - Remote The Dignify Solutions, LLCTechnical Business Analyst with Medicaid & Claims Module experience - RemoteJersey City, NJRemote10-12 years of experience as a Business Analyst with Minimum of 8+ years of experience in health care experience especially in MMIS domain. SQL: To validate data in backend tables (e.g., claim status, payment details, find members/providers, Benefit Plan).
Sr Data Analyst, Healthcare Claims Audit and Compliance (Hybrid NY) HF Management ServicesSr Data Analyst, Healthcare Claims Audit and Compliance (Hybrid NY)New York, New York$83,100–$120,360 / yearThis role partners with cross-functional teams to identify risks, evaluate controls, analyze claims and configuration data, and develop reporting that supports operational excellence, compliance, and payment accuracy. Demonstrated ability to develop innovative solutions to complex problems, leveraging advanced problem-solving skills and sound judgment to make critical, independent decisions within area of responsibility.
Claims Bus Tech Analyst II Blue Cross and Blue Shield AssociationClaims Bus Tech Analyst IINewark, NJ$87,300–$119,070 / yearResponsible for coordination throughout the Service Division of all Claims Operations'' technical requirements including global inventory reporting and aged claims analysis; claims stop governance, monitoring and maintenance; NASCO issue coordination and system request prioritization, submission and installation; files and table management; BRD review and subject matter expertise; Open Connect and BPM opportunity assessment and execution; EDI gateway claim edit project assessment and completion; general business level technical support for CSRs, PLogs, configuration, file updates and other projects. This technical analyst position is required in order to create a critically needed Service Division Claims Business Technical team to support the successful implementation of automation and efficiency projects/programs to ensure the achievement of claims timeliness and quality goals.
Data Analyst - Claims & Cost Containment ArloData Analyst - Claims & Cost ContainmentNew York, New YorkWe are seeking a Claims Data Analyst who will be responsible for reviewing stop-loss claims, identifying cost-containment opportunities, and generating insights that drive proactive intervention for members and employers. This role bridges analytics, risk management, and operations — ensuring Arlo’s plans perform efficiently while maintaining outstanding member outcomes.
Data Analyst - Claims & Cost Containment Railway Health IncData Analyst - Claims & Cost ContainmentNew York, NY$100,000–$150,000 / yearWe are seeking a Claims Data Analyst who will be responsible for reviewing stop-loss claims, identifying cost-containment opportunities, and generating insights that drive proactive intervention for members and employers. This role bridges analytics, risk management, and operations - ensuring Arlo's plans perform efficiently while maintaining outstanding member outcomes.
Workers Compensation Claims EDI Analyst W. R. Berkley CorpWorkers Compensation Claims EDI AnalystJersey City, NJ$90,000–$115,000 / yearWe provide a comprehensive portfolio of commercial property casualty insurance, automobile liability and workers' compensation, along with claim services, providing expertise to meet the unique business needs of our customers. Berkley Environmental is looking for an enthusiastic experienced EDI Analyst to partner between IT and our business units to monitor, support and maintain our business-critical Electronic Data Interchange (EDI) workflow.
Business Analyst (Claims), Senior Acentra HealthBusiness Analyst (Claims), SeniorNY$95,360–$119,200 / yearThis role would review, evaluate, and recommend solution for various business requirements; would provide a fully integrated solution ensuring accomplishment of business requirements; would collaborate with customers and stakeholders and use business modeling techniques to deliver effective "to be" operating models and roadmaps; and work to develop an integrated view of the solution and align project with the strategic business vision. Job Summary: Business Analyst, Specialist is responsible for logical design and functional behavior of the solutions involving complex information systems under no supervision for one or more systems including: Provider Enrollment, Claims, and Prior Authorization.
Sr Data Analyst, Healthcare Claims Audit and Compliance (Hybrid NY) HealthfirstSr Data Analyst, Healthcare Claims Audit and Compliance (Hybrid NY)New York, NY$83,100–$120,360 / yearThis role partners with cross-functional teams to identify risks, evaluate controls, analyze claims and configuration data, and develop reporting that supports operational excellence, compliance, and payment accuracy. Demonstrated ability to develop innovative solutions to complex problems, leveraging advanced problem-solving skills and sound judgment to make critical, independent decisions within area of responsibility.
Sr Data Analyst, Healthcare Claims Audit And Compliance (Hybrid NY) HealthfirstSr Data Analyst, Healthcare Claims Audit And Compliance (Hybrid NY)New York, NY$83,100–$120,360 / yearThis role partners with cross-functional teams to identify risks, evaluate controls, analyze claims and configuration data, and develop reporting that supports operational excellence, compliance, and payment accuracy. Demonstrated ability to develop innovative solutions to complex problems, leveraging advanced problem-solving skills and sound judgment to make critical, independent decisions within area of responsibility.
Workers Compensation Claims EDI Analyst BerkleyWorkers Compensation Claims EDI AnalystJersey City, New Jersey$90,000–$115,000 / yearWe provide a comprehensive portfolio of commercial property casualty insurance, automobile liability and workers’ compensation, along with claim services, providing expertise to meet the unique business needs of our customers. Responsibilities: Berkley Environmental is looking for an enthusiastic experienced EDI Analyst to partner between IT and our business units to monitor, support and maintain our business-critical Electronic Data Interchange (EDI) workflow.
NewManager Claims Healthcare VillageCareManager Claims HealthcareNew York, NY$118,135.58–$132,902.53 / yearExperience: This position requires a minimum of 5 + years' experience in claims analytics performing increasingly complex data analysis and report/dashboard development, in a healthcare setting, and at least 2 years' experience managing and training staff. VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services.
Data Exchange Analyst - Claims Operations Capital Rx, Inc.Data Exchange Analyst - Claims OperationsNew York, NY$96,800–$121,000 / yearJudi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Judi Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers, Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and. This role is responsible for executing and monitoring outbound eligibility, claims, formulary, and network reporting; supporting manual claims activities; assisting with custome data feed configurations; and participating in historical data loads and connectivity setups for JUDI Rx clients.
Mass Tort And Complex Casualty - Senior Claims Adjuster American International GroupMass Tort And Complex Casualty - Senior Claims AdjusterJersey City, NJ$76,000–$100,000 / yearAs an experienced professional, in this role you'll deal with sophisticated litigation and coverage issues, including long-tail bodily injury and property damage exposures, claims arising under Coverage B of Primary/Excess CGL policies, construction defect, as well as environmental and toxic tort claims. Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience.
NewData Exchange Analyst - Claim Ops (Tpa) Capital Rx, Inc.Data Exchange Analyst - Claim Ops (Tpa)New York, NY$96,800–$121,000 / yearKey Responsibilities: Data Integration & Mapping: Design, develop, and maintain data mappings and transformations for incoming and outgoing healthcare data files: 837/835 - claims & remittance, 270/271 - eligibility and responses, 278 - Prior Auth, 276/277 - claim status, 999/TA1 - file level acknowledgement as well as proprietary formats. Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Judi Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers, Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and.
NewData Exchange Analyst - Claims Operations Capital Rx LLCData Exchange Analyst - Claims OperationsNew York, NY$96,800–$121,000 / yearJudi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Judi Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers, Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and. This role is responsible for executing and monitoring outbound eligibility, claims, formulary, and network reporting; supporting manual claims activities; assisting with custome data feed configurations; and participating in historical data loads and connectivity setups for JUDI Rx clients.
CLAIM ADMIN-PRGM ANALYST Dassault Falcon Jet CorpCLAIM ADMIN-PRGM ANALYSTLittle Ferry, NJ$70,000–$90,000 / yearThis includes reviewing maintenance transactions and invoices, checking incoming claims for completeness and accuracy, identifying missing or inconsistent information, preparing documentation for invoice payment, and maintaining KPIs. PRINCIPAL DUTIES/RESPONSIBILITIES (ESSENTIAL FUNCTIONS): Review all incoming claims for completeness and accuracy, identify missing or inconsistent information, and coordinate with internal teams or external service providers to obtain required documentation and resolve discrepancies.
NewData Exchange Analyst - Claim Ops TPA Capital Rx LLCData Exchange Analyst - Claim Ops TPANew York, NY$96,800–$121,000 / yearKey Responsibilities: Data Integration & Mapping: Design, develop, and maintain data mappings and transformations for incoming and outgoing healthcare data files: 837/835 - claims & remittance, 270/271 - eligibility and responses, 278 - Prior Auth, 276/277 - claim status, 999/TA1 - file level acknowledgement as well as proprietary formats. Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Judi Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers, Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and.
Senior Director, Insurance Claims Advisory NTT DATA Group CorpSenior Director, Insurance Claims AdvisoryNJ$160,000–$296,000 / yearEcosystem & Partnership Leadership: Develop joint GTM motions with key alliance partners and Independent Software Vendors (ISVs) in the insurance space (e.g., Guidewire, Duck Creek, Majesco, Verisk). to amplify market reach and deliver integrated client solutions. A critical component of this role is serving as the primary pre-sales Claims domain expert for the North American P&C and L&A sales team, translating complex IT capabilities into tangible business outcomes (e.g., improved claims efficiency, lower loss ratio).
NewTSIB Claims Manager Turner Construction CoTSIB Claims ManagerNew York, NY$114,000–$145,000 / yearThis is a front-line, hands-on role responsible for managing a diverse portfolio of construction general liability, construction defect, builders' risk, and property damage claims, with a strong emphasis on NY labor law, litigation management, claim strategy, and stakeholder partnership. The Claims Manager works closely with the Regional Director of Claims and serves as a strategic claims partner to Turner Risk Management, project teams, Safety, and insurer partners.
Group Insurance Team Lead, Claims (STD) / Virtual Prudential Financial IncGroup Insurance Team Lead, Claims (STD) / VirtualNewark, NJ$89,000–$147,000 / yearWe measure our long-term success on our ability to deliver value for shareholders, meet customer needs, attract, and develop the best talent in our industry, offer an inclusive work environment where employees can develop to their full potential and give back to the communities where we live and work. For over 150 years, Prudential's diverse and talented employees have been committed to helping employees and their families grow and protect their wealth through a variety of products and services, including Group Disability Insurance.
Manager - Risk Management (Claims) WESCOManager - Risk Management (Claims)Cranbury, NJYou will partner with carriers, third-party administrators (TPAs), brokers, legal counsel, and internal stakeholders to manage complex claims, support litigation and settlement strategies, represent the company in mediations and other claim proceedings, and drive continuous improvement in claims handling practices. You will manage the Workers' Compensation Analyst, Risk Management (Claims) and serve as Wesco's primary point of contact for claim-related matters, ensuring timely, accurate, and cost-effective claim resolution while maintaining compliance with company policies and regulatory requirements.